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Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
12 05, 2023;77 (Suppl 6): S455-S462.

Infectious Inequity: How the Gut Microbiome and Social Determinants of Health May Contribute to Clostridioides difficile Infection Among Racial and Ethnic Minorities.

Kelly R Reveles, Kelsey A Strey, Jacinda C Abdul-Mutakabbir, V Mateo Mendoza, Joseph J Carreno
Author Information
  1. Kelly R Reveles: Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, Austin, Texas, USA.
  2. Kelsey A Strey: Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, Austin, Texas, USA.
  3. Jacinda C Abdul-Mutakabbir: Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California-San Diego, La Jolla, California, USA.
  4. V Mateo Mendoza: Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, Austin, Texas, USA.
  5. Joseph J Carreno: Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, New York, USA.
PMID: 38051968 DOI: 10.1093/cid/ciad586

Abstract

Infectious diseases are a leading contributor to death in the United States, and racial differences in clinical outcomes have been increasingly reported. Clostridioides difficile infection (CDI) is a growing public health concern, as it causes nearly half a million infections per year and considerable excess hospital costs. Concurrent with other infectious diseases, recent literature denotes racial disparities in CDI incidence rates, mortality, and associated morbidity. Of note, investigations into CDI and causative factors suggest that inequities in health-related social needs and other social determinants of health (SDoH) may cause disruption to the gut microbiome, thereby contributing to the observed deleterious outcomes in racially and ethnically minoritized individuals. Despite these discoveries, there is limited literature that provides context for the recognized racial disparities in CDI, particularly the influence of structural and systemic barriers. Here, we synthesize the available literature describing racial inequities in CDI outcomes and discuss the interrelationship of SDoH on microbiome dysregulation. Finally, we provide actionable considerations for infectious diseases professionals to aid in narrowing CDI equity gaps.

Keywords

Clostridioides difficile health disparities infectious diseases microbiome social determinants of health

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Grants

  1. K12 HD113189/NICHD NIH HHS
  2. P30 AG044271/NIA NIH HHS
  3. R25 AI147376/NIAID NIH HHS

MeSH Term

Humans
Gastrointestinal Microbiome
Ethnic and Racial Minorities
Social Determinants of Health
Communicable Diseases
Clostridium Infections
Journal Article

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